Thomson

It’s a heck of a way to run a pre-election campaign. On the eve of an expected election, politicians usually spend their time playing up good news, downplaying the bad, shaking hands and kissing babies.

Millie Nelles, 64, participated in a clinical trial of a neuroprotecant drug that protects the human brain against the damaging effects of stroke. She says the drug saved her life.

Photograph by: Stuart Gradon
, Calgary Herald

CALGARY — Millie Nelles’s brain was so “worn out,” she was sure she was going to die.

First, a rare brain disorder that had caused her excruciating pain for more than a year meant she needed surgery to ease the ache. But soon after the procedure, doctors discovered she had a brain aneurysm. That meant she needed another operation to repair the damage — a delicate procedure with a high likelihood of leaving Nelles at risk for stroke.

“I was worn out, and so was my brain,” said Nelles, who crafted farewell video messages and letters to her husband, children and close friends before undergoing the second brain operation roughly four years ago.

“I was positive I wasn’t going to make the surgery.”

When her medical team approached her to see if she was willing to participate in a clinical trial testing whether a new drug could protect the human brain against the damaging effects of stroke, Nelles said yes.

The Calgarian was one of 185 patients from hospitals across Canada and the United States in a landmark study, led by University of Calgary stroke neurologist Dr. Michael Hill, published Sunday in the prestigious Lancet Neurology.

The researchers say their drug, NA-1, has succeeded where more than 1,000 other attempts to develop similar drugs have failed to “make the leap between success in the lab and in humans” and ward off irreversible brain damage caused by strokes.

A neuroprotectant drug is highly sought after in stroke research.

Most strokes are ischemic — there’s an artery blockage in the brain that cuts off blood flow.

“The only treatment we have in an acute setting is to open the artery, restore the blood flow,” said Hill, director of the Foothills Medical Centre stroke unit, and U of C clinical neurosciences professor.

“If we could additionally give another drug that protects the brain once it’s not getting enough blood flow, stops that cascade, it would buy us a bit more time to restore blood flow possibly, and it would help patients get better,” said Hill, who conducted research at the Hotchkiss Brain Institute.

“That’s what we’re trying to do: we’re trying to save tissue from dying.”

Hill estimates more than 1,000 neuroprotectant medicines have been tested in animals, but none have been shown to be fit for humans.

The drug in the study published Sunday was first developed by Dr. Michael Tymianski at the Krembil Neuroscience Centre at the Toronto Western Hospital in the mid-1990s.

Since then, researchers have been working to ensure the drug was “robust enough to bring forward to testing in humans,” Hill said.

The research team took a unique approach to the study by aiming their efforts at situations where tiny strokes are already likely to occur and are easily measured: brain aneurysm repair.

The standard treatments of aneurysms, stenting and coiling, are touchy procedures that carry high risk of triggering small ischemic stroke in more than 90 per cent of patients.

The tiny strokes usually don’t cause widespread neurological disability, but they can, however, be observed via MRI scans following the procedure.

In a randomized, double-blinded trial conducted in hospitals across Canada in the United States, patients were given either NA-1 or a placebo.

The study showed those treated with the new drug had a reduced amount of brain damage following the aneurysm repair surgery; further, patients with ruptured brain aneurysm treated with the new drug all had positive outcomes, compared to 68 per cent of those who took the placebo.

“What we think we’ve shown is a proof of concept that you can treat human stroke and prevent the strokes from occurring with NA-1,” Hill said.

In Nelles’s case, she knew immediately she wanted to participate in the clinical trial.

“I said I would be happy to do that, because at least I could help other people,” said Nelles, 64.

It turned out in the randomized trial, Nelles was given the NA-1 drug.

Not only did she survive the surgery, but an MRI after the procedure was done revealed she hadn’t suffered any stroke.

“When found out it was the real drug, I honestly know this drug saved my life,” said Nelles, who works in payroll for a Calgary placement agency.

“It’s just an amazing feeling. I feel like through this, I can help others,” said Nelles, of her participation in the trial.

The stroke research team now hopes to take the research to the next stage: administering the drug to people who are having a stroke in the community. Ideally, they’d like to get permission to conduct the study so that the drug is given when the patient is in the ambulance, soon after the stroke occurs.

There are still several steps that must be successfully achieved before the drug could one day hit pharmacy shelves.

But where stroke recovery now involves neurological rewiring — using healthy parts of the brain to take over functions that have been lost — Hill envisions the drug one day sidestepping the irreversible damage in the first place.

Paralysis, loss of speech, the inability to smile — “all of those deficits would be things you could ward off if you could reduce the damage,” Hill said.

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